Provider Demographics
NPI:1821165150
Name:CAPPADORO, CARLA L (ARNP)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:L
Last Name:CAPPADORO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10945 DYLAN LOREN CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-4450
Mailing Address - Country:US
Mailing Address - Phone:407-249-3281
Mailing Address - Fax:407-249-3282
Practice Address - Street 1:10945 DYLAN LOREN CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4450
Practice Address - Country:US
Practice Address - Phone:407-249-3281
Practice Address - Fax:407-249-3282
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1944522363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000088400Medicaid
FLAD581YMedicare PIN